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NLM AIDSLINE
Who uses HIV prevention counseling for women?
Milstein B; Cabral R; Kelsch C; Galavotti C; Lupton K; Green B; Gielen
January 30, 1997
Int Conf AIDS. 1996 Jul 7-12;11(1):184 (abstract no. Mo.D.1758). Unique

Objective: Understanding factors that lead to greater service use among women at risk for or infected with HIV can help service providers more effectively allocate resources and target intervention efforts. This study identifies demographic, HIV risk, and psychosocial factors associated with participation in an HIV counseling intervention delivered to women by peer paraprofessionals (Advocates) in two U.S. cities. Methods: During 1993-1994, women at risk for HIV infection recruited from homeless shelters, drug treatment facilities, and public housing projects (n=225), and HIV+ women recruited from outpatient HIV clinics (n=91), were enrolled in an HIV prevention project Project CARES). Participants received a baseline interview and were offered (1) support and referrals for health and social service needs, and (2) individual and group counseling on reproductive decision-making, condom use, contraceptive use, and reproductive health service use. The intervention was delivered by specially-trained Advocates over a period of 6 months. Differences in mean number of contacts with an Advocate were evaluated (t-test) for women who received greater than or equal to1 contact. Results: Women were ages 15-44 and predominantly African-American (88%). Of women with at least one contact (77%), the median was 7 (range=1-56). For women at risk, mean number of contacts was greater for women living with children under 18 (p is less than .001; mean of x contacts=13 vs 8) and involved in support groups, mental health counseling, or other HIV-related projects (p is less than .01; mean of x contacts=11 vs 8). Among HIV+ women, more Advocate contacts occurred among those with high self-efficacy for condom use with a main partner (p is less than 01; mean of x contacts=11 vs 5), no speedball use (p is less than .05; mean of x contacts=11 vs 7) and no cocaine use (p is less than .01; mean of x contacts=11 vs 7) in the last month. Conclusion: Nearly 8 in 10 women took advantage of available services, and most had multiple service contacts. Factors associated with greater service use varied for women at risk for HIV compared to HIV+ women. Findings suggest that women who use peer counseling services most intensively may have greater needs for service (e.g. child-related concerns), be willing to seek external support, and not be currently using drugs. Interventions sensitive to a range of needs may be most attractive to women at risk for HIV infection or transmission.

*Counseling *Health Services/UTILIZATION *HIV Infections/PREVENTION & CONTROL *Patient Acceptance of Health Care

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